title: Baseline characteristics and effects of ten years of growth hormone (GH) replacement therapy in adults previously treated with pituitary irradiation.
abstract: BACKGROUND
  Little is known of the importance of previous irradiation therapy for baseline characteristics and responsiveness to GH replacement in GH deficient (GHD) adults.
  
  
  OBJECTIVE
  In this prospective, single-centre, open-label study, the effects of 10-year GH replacement were determined in 18 GHD adults that had previously received conventional external fractionated pituitary irradiation therapy (IRR group) and 18 non-irradiated GHD patients (non-IRR group). All patients had adult onset disease and complete deficiency of anterior pituitary hormones and both groups were comparable in terms of age, gender, body mass index (BMI), and waist:hip ratio.
  
  
  RESULTS
  At baseline, IRR patients had higher serum triglyceride (TG) and insulin levels and lower high density lipoprotein (HDL)-cholesterol (HDL-C) level than non-IRR patients (all p<0.05). The 10-year GH replacement improved body composition, bone mass and serum lipid profile without any between-group differences, except for a marginally more beneficial response in serum TG level in the IRR patients. After 10 years, there was no between-group difference in any variable after correction for a higher replacement dose of glucocorticoids in the IRR patients at study end using an analysis of covariance. During the 10-year GH replacement, 5 IRR patients suffered from vascular events (2 fatal) whereas only one non-fatal vascular event occurred in the non-IRR patients.
  
  
  CONCLUSIONS
  IRR patients with GHD display a more severely impaired cardiovascular risk profile at baseline, which was reversed by the 10-year GH replacement after correction for the higher glucocorticoid dose at study end. However, vascular events occurred more frequently in the IRR patients.
authors.affiliation: Department of Endocrinology, Gröna Stråket 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. Electronic address: mariam.elbornsson@medic.gu.se.
authors.forename: Mariam
authors.initials: M
authors.lastname: Elbornsson
authors.forename: Galina
authors.initials: G
authors.lastname: Götherström
authors.forename: Bengt-Åke
authors.initials: BÅ
authors.lastname: Bengtsson
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Johannsson
authors.forename: Johan
authors.initials: J
authors.lastname: Svensson
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000532:radiotherapy; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010910:Pituitary Irradiation; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D008055:Lipids; D019382:Human Growth Hormone; D005947:Glucose
keywords: Body composition; Bone mass; Glucose homeostasis; Growth hormone deficiency; Pituitary irradiation; Serum lipid pattern; Vascular events